We carried out a review of the data available to us about Mountbatten IW on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Mountbatten IW, you can give feedback on this service.
Earl Mountbatten Hospice (EMH) serves the adult population of the Isle of Wight (IOW). Services are provided from the In-Patient Unit (IPU) and the local hospital. Day Services and Out-Patient appointments are provided from the John Cheverton Centre (JJC). People are supported in their own homes by the Rapid discharge and the Hospice Care at Home team. The hospice also offered a range of other bespoke services to people and their families including psychological support, creative and complementary therapies and a bereavement service. The hospice has a large multi-professional team consisting of medical staff, nurses, a psychologist, social worker, therapists and chaplaincy supported by people facing volunteers.
There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The Earl Mountbatten Hospice provided an outstanding service that creatively enabled people to choose where they wanted to receive end of life care (EOL) and responded promptly to clinical deterioration in times of need. People spoke of a service that was tailor-made for them, highly personalised and focussed on their individual needs and that of their families. EMH had developed their range of services innovatively with local agencies to ensure their local population would receive the support they needed at the time they needed it and in a way and place that best suited them.
The hospice worked innovatively with their local hospital and was highly responsive to ensure people were discharged from hospital in a timely manner so that they could receive EOL care at home when this was their preference. Through this joint working people who would not traditionally access hospice care had also been given the choice to receive their EOL care in a hospice. The various departments within this hospice worked well together so that people had a seamless experience of moving from one department to another as the need arose.
People, their relatives and staff spoke overwhelmingly of the positive support, guidance and healthcare interventions people had received. They were full of praise for the staff in terms of their exceptional kindness, compassion and knowledge about end of life matters. Staff went out of their way to support the needs of their wider community which included providing care and support to children and people living with dementia at the end of their life.
The Day Services used their Schools Project creatively to support people’s desire to remain useful and contribute to society till the end of their lives. Through this project people had an open and honest dialogue with their local young people about palliative care and their end of life experiences. People told us this how this had made them feel valued and they were proud to be able to teach others through their life stories.
Managers showed outstanding leadership and they recognised, promoted and implemented innovative ways of working in order to provide a high-quality service. This forward thinking approach had resulted in service commissioning arrangements that ensured people received high quality integrated community care to support their preference to receive end of their life care at home.
The management team promoted a culture of openness, reflection and excellence. Staff were involved in the development of the values and vision of the service. An outstanding example of enabling staff to contribute to personal and hospice development was the bespoke ‘Well-led: Leading from the Middle programme designed for middle managers across the organisation. We saw this project had empowered staff to work on operational challenges and creatively deliver tangible outcomes for the hospice. Governance of the service was of a high standard and robust quality assurance systems were in place that showed people were right to have confidence in this local hospice.
The hospice offered end of life care training opportunities for their staff and other health and social care professionals. Through this training and other service developments the hospice had enabled people to receive end of life care closer to home and reduced the need for hospital admissions. Staff were involved in the development of working practice, listened to and supported to offer high quality end of life healthcare and support.
People's informed consent was embodied into all work that was undertaken at the hospice and people who did not have capacity to consent to their care and treatment had their rights protected under the Mental Capacity Act (MCA) 2005.
People were protected from harm and abuse and robust staff recruitment procedures were followed to keep people safe. There were sufficient staff to meet people's individual needs and to respond flexibly to changes and unforeseen emergencies. Systems were effective to manage known risks associated with people's care and treatment needs such as falls, pressure sores, poor nutrition and hospice acquired infections.
Guidance was provided to ensure people were supported to eat and drink sufficiently and adjustments were made to ensure people at risk of choking could eat and drink safely. Regular reviews took place of people's symptoms and changes were made as required to ensure people's pain would be well managed.
The service listened to people, families and staff, involving them in the running and development of the service. They actively sought out their views and used feedback as an opportunity to improve and develop the service. There was a kindness and warmth about the management team that made them approachable to everyone and people knew them by their first names and told us they were visible and solved matters when they were raised.
We spoke with nursing, care and medical staff. Staff were aware of how people should be supported, their individual likes and dislikes and the help they required. Staff stated they felt they had sufficient time to meet people's needs. Staff also told us they had attended relevant training and had all the necessary equipment to safely care for people.
We found good recruitment and induction procedures were followed. Care plans and related care records were appropriate to people's needs. Records related to the running of the service were well maintained and stored securely. People's privacy and dignity were maintained and they or their relatives were involved in relevant decisions about their care.
We spoke with 2 of the 11 people who were receiving inpatient care at the time of our inspection. We also spoke with one relative. Other people were too frail to speak with us. People told us that they could make decisions and that the staff were 'very nice and professional'. People told us the standard of care was 'fantastic'. We were told that although staff were at times 'a bit rushed' they were always 'kind and respectful'. We were told that staff were available when people needed them and knew what care they required. People told us that they felt safe and that their privacy was respected. People were complimentary about the meals provided which they said were of a 'good quality'.
However we found that people were not always fully consulted about their preferences and fully documented care plans were not in place for all people. This placed people at risk that they will not receive consistent individual care to meet their needs and wishes.